Until she fainted in 2012, Alicia didn’t know she was sick. Feeling tired and out of breath were “normal for me,” says the now 52-year-old single mom. The Glenside resident believed she felt that way because she was overweight and out of shape. She was working 10- to 12-hours daily attending her daughter Shannon’s high school track meets and working part-time on an online MBA degree.

After suffering a seizure in 2000, Brain learned that a virus had destroyed the lower third of his heart. He received a defibrillator and a dual pacemaker. More than a decade later, his heart function began to deteriorate further. So his doctors in the Lehigh Valley recommended that Brian go to the Temple Heart & Vascular Institute—where, at the age of 70, he received a heart transplant in December 2013.

Over the last two decades, MCSDs have been developed to augment or supplant failing myocardial performance. This therapy has been used successfully as a bridge to heart transplantation, a bridge to recovery, and as permanent implantation or "destination therapy" for intractable heart failure. Although heart transplantation offers life-saving therapy for selected patients, its use is limited by a supply of donor organs that currently meets less than one-tenth the need. As a consequence, the number of MCSD implantations has increased in recent years.

The response to therapy with a fixed dose combination of isosorbide dinitrate and hydralazine (FDC I/H) is enhanced in African Americans with heart failure and reduced ejection fraction (HFrEF) when...

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